T’was The Week Before Christmas

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T’was the week before Christmas and Dawn Wilson, mamager of the Levin and Otaki PHOs under the Central PHO, played at being Santa. Dawn is the manager of the Horowhenua and Otaki Primary Health Organisation (PHO) charged with establishing Integrated Family Health Centres (IFHC). In the very beautiful and functional Horowhenua District Council Chambers, Dawn gave a presentation to about 25 people on the vision for the soon to be established Integrated Family Health Centre.

This new model of care arises out of the decision to combine MidCentral Health’s four PHOs and with the mandate from government to establish IFHC within our communities.

It simply means to provide the majority of community services under one roof, with health professionals working together to determine health needs and to have access to the same health information.

Although the focus of this presentation was Levin, the model is the same for Otaki and we will benefit from what happens at the Horowhenua Health Centre.

What Will Be Different

The new way of care proposes that when using multiple services there will not be the need for repeated assessments and registration. There will be more efficient and therefore more care available despite there being fewer GPs and it will cost the taxpayer less. There will be more personal responsiveness and it will be easier to navigate through the system. With the shared IT there will be no conflicting information and advice and no more repeated and unnecessary assessments.

In summary good information, good decisions by health providers with better information with savings to the individual and to the system.

Drivers for Change

The drivers for this new way are four fold:- the current workforce is not sustainable- the costs are not sustainable- available services are not being made the best use of- there is significant room for improvement.

National Goals

These are nationwide goals attempting to develop a more personalized PHO system, to provide more services closer to home, to make Kiwis healthier and to reduce pressure on the hospitals.

Statistics

Some of the statistics presented were scary. There is difficulty recruiting general practitioners to Levin and $250,000 has been spent so far trying to do so. There are only 4 remaining (from a high of 9) in Levin and they have had 100930 visits in the last 12 months. We are blessed in Otaki with a stable GP workforce.

All across the MidCentral district there is the same problem of an aging population. To cope with this the district needs to recruit 10 more GPs per year for the next 10 years.

Aspirations

The Integrated Family Health Centres have some laudable aims:

- To reduce trips to A & E by 30%- To reduce avoidable admissions by over 65 years old by 20%- To increase enrollments of Maori- To increase the services to chronic patients by structured care plans by 80%- Patients to have access to health records- Health professional all have the same access to health records.- All health professionals to have the same assessment and care planning framework- and finally clinical leadership will drive service development

Progress to Date

Staff is being recruited and the planning process of a shared vision has started. There has been a lot of work in the background building strong foundations for the staff and community. The clinicians have been working together on a governance framework to ensure stability and sustainability. The IT needs which are critical to the success of the project are being assessed as has the management structure and development of shared work programmes.

Future Considerations

There will be linkages to the wider NGO sector (eg Cancer Society) and welfare agencies with wider communication across the whole community. The community will be involved in shaping services at a local level.

This is significant for Otaki as this model will also (and in fact is now) be used by the Otaki Medical Centre. Keep a look out for future public meeting to discuss ongoing progress. Dawn Wilson has promised community involvement but that only works if we become involved in the care of our own health and provision of our own health services.